Thoracic surgery bronchoscopy

THORACIC OPERATION

Bronchoscopy

Objective

In cases of suspected bronchial lesions:

•   Endoscopy

•   For visualization of the trachea, main bronchi and their openings and the segmental bronchi 

•   Obtaining material for histopathologic and bacteriologic examination if required 

•   Foreign body removal.

Position

Supine.

Anesthesia

General.

Procedure

1.  The head is lowered.

2.  Well-lubricated scope is inserted into the mouth.

3.  The epiglottis is elevated with the tip of the bronchoscope and the scope is passed into the trachea.

4.  The scope is advanced into the bronchi.

5.  Bronchial washings, biopsy, may be obtained.

6.  The bronchial passages are well suctioned, and the scope is removed slowly.

Instruments

Rigid bronchoscopy

•   Rigid fiberoptic bronchoscope (Fig 19.8)

•   Endotracheal adaptor 

•   Fiberoptic telescope 

•   Fiberoptic light cords (2) 

•   Suction cannula (Fig. 19.9) 

•   Suction tubing 

•   Specimen collectors 

•   Biopsy forceps 

•   Sponge carriers (2) (Fig. 19.10)

•   Grasping forceps 

•   Lubricant

•   Bronchoscopy sponges 

•   Small basin with sterile saline and syringe 

•   Telfa dressing pads and 25 gauge needle 

•   Laser may be employed.

Flexible bronchoscopy

•   Flexible fiberoptic bronchoscope 

•   Endotracheal adaptor 

•   Fiberoptic light cord 

•   Biopsy forceps 

•   Brush

•   Culture jar for biopsy specimen 

•   Small basin with sterile saline and syringe 

•   Suction tubing 

•   Specimen collector 

•   Lubricant

•   Telfa dressing pads and 25 gauge needle.

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